Treatment of bipolar disorder in older adults

Sajatovic, Martha

doi:10.1002/gps.719

Cited by 97 publications

(41 citation statements)

References 66 publications

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“…It is understandable therefore that affective disorders have become a major mental health concern in the growing geriatric population [Jefferson, 1983;Sajatovic, 2002;Young and Klerman, 1992]. Hence, there is a major need to devise strategies of treatment and prophylaxis for this age group.…”

Section: Introductionmentioning

confidence: 98%

“…Affective disorders constitute a significant public health problem among older adults, often leading to functional impairment and substantial utilization of health care resources [Sajatovic, 2002;Young and Klerman, 1992]. In the United States, although this age group represents about 11% of the population, it has the highest suicide rate and accounts for 17% of all suicides [Jefferson, 1983].…”

Section: Introductionmentioning

confidence: 99%

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Lithium therapy for unipolar and bipolar depression among the middle-aged and older adult patient subpopulation

et al. 2007

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Affective disorders are a major cause of morbidity and disability among middle-aged and older people. Thus, the prophylaxis of both unipolar depression and bipolar disorder in this patient subpopulation is an important task of psychiatrists and other physicians. Although lithium remains an effective prophylactic and treatment agent in younger individuals with bipolar disorder, its prophylactic efficacy and tolerability has not been thoroughly investigated among middle aged and older people with unipolar depression and bipolar disorder. Our study is based on a mirror-image design that compared the clinical course with lithium treatment and the clinical course prior to lithium treatment based on a retrospective chart review. We examined the results obtained with long-term lithium maintenance in a group of 60 middle-aged and older adult patients (age >60 years) with unipolar depression and bipolar disorder. More specifically, we analyzed changes of frequency, severity, and duration of depressive or manic relapses, rate and duration of hospitalizations and suicidal behavior (thoughts or attempts), and various assessments of outcome. A significant reduction was found on all indices during lithium therapy compared to before lithium treatment, attesting to the prophylactic efficacy of long-term lithium in unipolar depression and bipolar disorder. The range of side effects in our sample was similar to that found in other reports in this age group. The probability of relapse and recurrence in patients with bipolar disorder and with unipolar depression can be significantly decreased by lithium prophylaxis. Further investigation is mandated to confirm these findings under double-blind conditions.

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Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Lithium therapy for unipolar and bipolar depression among the middle-aged and older adult patient subpopulation

et al. 2007

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“…A preliminary analysis of manic patients aged 50 years or more suggests efficacy of olanzapine monotherapy [101]. Also, preliminary experience has suggested a role for quetiapine in management of BP elders [102,103]. In addition, Shulman and colleagues [104] and Frye [105] noted response to clozapine in geriatric manic patients.…”

Section: Pharmacodynamic Drug-drug Interactionsmentioning

confidence: 99%

“…Clinical experience suggests that many elders with BP disorder receive combined psychotropic regimens [77,103]. The optimal duration of adjunctive agents, ie, antidepressants or antipsychotic agents, after successful treatment is not defined in elderly BP patients.…”

Section: Continuation/maintenance Treatmentmentioning

confidence: 99%

Evidence-Based Pharmacological Treatment of Geriatric Bipolar Disorder

Young

2005

Psychiatric Clinics of North America

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“…Available treatment guidelines do not provide specific recommendations for treatment of older adults with BD (Van Gerpen et al, 1999;Sajatovic, 2002a) and it is common for health services studies in BD to focus on younger populations (Russo et al, 2002). Anticonvulsant medications have supplemented the use of lithium therapy in older adults with BD (Shulman et al, 2003); while specifics regarding use remain to be clarified (Sajatovic, 2002b;Charney et al, 2003).…”

Section: Introductionmentioning

confidence: 98%

Lamotrigine therapy in elderly patients with epilepsy, bipolar disorder or dementia

Sajatovic

Ramsay

Nanry

et al. 2007

Int J Geriat Psychiatry

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Review of the available literature suggests lamotrigine is effective and well tolerated in elderly patients with epilepsy and relatively well-tolerated and may be effective in delaying mood relapse, particularly in the depressive pole, in patients with BD. While very limited literature suggests that lamotrigine may be effective and relatively well-tolerated in patients with dementia, further studies are needed.

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Treatment of bipolar disorder in older adults

Abstract: There are a number of areas of needed future research in late life bipolar disorder.

Cited by 97 publications

References 66 publications

Lithium therapy for unipolar and bipolar depression among the middle-aged and older adult patient subpopulation

Lithium therapy for unipolar and bipolar depression among the middle-aged and older adult patient subpopulation

Evidence-Based Pharmacological Treatment of Geriatric Bipolar Disorder

Lamotrigine therapy in elderly patients with epilepsy, bipolar disorder or dementia

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